NPI | 1598805236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ME PS918) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 2879) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2007-07-08 |