| NPI | 1275332124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: CO PSY000.4805) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: DC PSY1000947) |
| 103TF0200X Psychologist, Forensic (Licence: MD 05606) | |
| 103TF0200X Psychologist, Forensic (Licence: VA 0810005165) | |
| 103TF0200X Psychologist, Forensic (Licence: NJ 35si00597300) | |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-03-12 |