NPI | 1992028971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OK 1080) |
Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: OK 1080) |
Enumeration Date | 2010-03-05 |
Last Update Date | 2010-03-05 |