| NPI | 1396765780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH P.4051) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 4051) |
| 103TC1900X Psychologist Counseling (Licence: OH 4051) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-01-14 |