| NPI | 1427203223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM PSY20250123) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NM PSY20240077) |
| 103TS0200X Psychologist, School (Licence: NJ 578485) | |
| 103TS0200X Psychologist, School (Licence: PA 10641367) | |
| 103T00000X Psychologist (Licence: PA PS016044) | |
| 103T00000X Psychologist (Licence: NJ 35SI00461200) | |
| 103T00000X Psychologist (Licence: DE B10000996) | |
| 103TS0200X Psychologist, School (Licence: NM 429721) | |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2026-01-15 |