| NPI | 1043495310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: CT 002834) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2024-04-19 |