| NPI | 1568958858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TH0100X Psychologist, Health Service | |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |