NPI | 1679598072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4675) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN LP4675) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2025-09-11 |