NPI | 1932227584 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 1164) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AK 400) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2015-05-12 |