| NPI | 1497846273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 131) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 0133) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-04-04 |