| NPI | 1376181404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38348) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: TX 38348) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 38348) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 38348) | |
| 103TF0000X Psychologist, Family (Licence: TX 38348) | |
| 103TF0000X Psychologist, Family | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: TX 38348) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 38348) | |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |