NPI | 1922217462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: DE B1 0000321) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PA PS-003891-L) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2007-07-08 |