NPI | 1831327832 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 24334) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 31031) |
Enumeration Date | 2009-06-29 |
Last Update Date | 2009-06-29 |