| NPI | 1972636512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OK 1267) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: FL PY-9235) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2019-12-20 |