NPI | 1821106600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OH 3294) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NJ 1650) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2007-07-08 |