NPI | 1447308978 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 6076) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-004400) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2007-07-08 |