NPI | 1487199949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 10187979-2501) |
Enumeration Date | 2016-12-19 |
Last Update Date | 2017-02-09 |