| NPI | 1598837775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS-007473-L) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103T00000X Psychologist (Licence: PA PS007473) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2023-05-25 |