NPI | 1326320920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: HI PSY-1841) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: HI PSY-1841) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: HI PSY-1841) | |
Enumeration Date | 2011-09-09 |
Last Update Date | 2023-08-03 |