NPI | 1841204989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MN 2908) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 0136) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2009-04-20 |