| NPI | 1235226127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 4659) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: OH 4659) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2009-08-17 |