NPI | 1932545381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9635) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
Enumeration Date | 2013-05-13 |
Last Update Date | 2024-06-16 |