| NPI | 1295993863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NV 0699) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: NV 0699) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NV 0699) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NV 0699) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NV 0699) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NV 0699) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NV 0699) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2014-11-07 |