NPI | 1851975056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: WI 4078-57) |
Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY61278527) |
Enumeration Date | 2021-05-12 |
Last Update Date | 2024-09-26 |