NPI | 1710553573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38710) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: TX 38710) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 38710) | |
103TC0700X Psychologist, Clinical (Licence: TX 38710) | |
103TH0004X Psychologist, Health (Licence: TX 38710) | |
Enumeration Date | 2021-06-02 |
Last Update Date | 2023-12-28 |