NPI | 1902856149 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS002902L) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PA PS002902L) |
Enumeration Date | 2006-05-10 |
Last Update Date | 2013-06-06 |