| NPI | 1013341072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH P.08352) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OH P.08352) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2024-08-27 |