NPI | 1538494273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: TN P0000000266) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TN P0000000266) |
Enumeration Date | 2009-10-14 |
Last Update Date | 2009-10-14 |