NPI | 1598792905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS.004179-L) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS004179L) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2015-03-18 |