| NPI | 1285721951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NH 1282) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NH 601) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2014-04-15 |