| NPI | 1588130660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD A0496) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MD CER87994B7B7L9) |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2024-10-29 |