| NPI | 1134454036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: OK 1083) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OK 1083) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2024-11-07 |