NPI | 1932286911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401003279) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301012326) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |