NPI | 1760994313 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0001940) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 1940) |
Enumeration Date | 2017-11-03 |
Last Update Date | 2023-04-28 |