NPI | 1447317227 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY5474) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: FL PY5474) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2017-01-23 |