NPI | 1659622124 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: ME PS2658) |
Additional Taxonomies | 103T00000X Psychologist (Licence: UT 9695351-2501) |
Enumeration Date | 2012-09-25 |
Last Update Date | 2025-06-23 |