NPI | 1689793556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B1-0011356) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MD 02834) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2023-08-07 |