| NPI | 1780310201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-07-27 |