NPI | 1548320989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 2806) |
Additional Taxonomies | 103TS0200X Psychologist, School |
Enumeration Date | 2006-12-08 |
Last Update Date | 2007-07-26 |