| NPI | 1598091985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 04627) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MD CER-152895-W5D7H2) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2024-11-06 |