NPI | 1619041035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: DE B1-595) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: PA PS003893-L) |
Enumeration Date | 2006-11-17 |
Last Update Date | 2007-07-08 |