| NPI | 1396806030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 682MP) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.010829) |
| 103T00000X Psychologist (Licence: LA 682) | |
| 103TC0700X Psychologist, Clinical (Licence: LA 682) | |
| 103TH0100X Psychologist, Health Service (Licence: IL 071.010829) | |
| 103TH0100X Psychologist, Health Service (Licence: LA 682) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2025-06-28 |