NPI | 1972543338 |
---|---|
Former Name | LUIS A RIVERA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS008271L) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS008271L) |
103TB0200X Psychologist Cognitive & Behavioral (Licence: PA PS008271L) | |
Enumeration Date | 2006-06-07 |
Last Update Date | 2017-12-22 |