| NPI | 1538837026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MT PSY-PSY-LIC-3642) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MT PSY-PDS-APP-3551) |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2021-10-27 |