NPI | 1740230937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS008059L) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS008059L) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2013-06-07 |