NPI | 1700955994 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2681) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 2681) |
Enumeration Date | 2006-11-06 |
Last Update Date | 2013-06-17 |