NPI | 1982351920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS019430) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS019430) |
103TC1900X Psychologist, Counseling (Licence: PA PS019430) | |
103TH0100X Psychologist, Health Service (Licence: PA PS019430) | |
Enumeration Date | 2022-03-09 |
Last Update Date | 2022-03-09 |