NPI | 1518142041 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MS 33521) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MS 33521) |
Enumeration Date | 2008-01-03 |
Last Update Date | 2008-01-03 |