NPI | 1841318433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: AK 567) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AK 567) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2018-07-26 |