NPI | 1538529821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B1-0000989) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS017632) |
Enumeration Date | 2016-02-29 |
Last Update Date | 2016-02-29 |