NPI | 1538996830 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810008519) |
Enumeration Date | 2024-09-19 |
Last Update Date | 2024-09-19 |