NPI | 1457426215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: WI 1553-057) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 1553-057) |
Enumeration Date | 2006-11-21 |
Last Update Date | 2008-09-30 |