NPI | 1750307427 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10893) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MD 03845) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2024-09-11 |