NPI | 1851629844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 1844) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling |
Enumeration Date | 2009-12-02 |
Last Update Date | 2009-12-02 |