| NPI | 1437453008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 34302) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: TX 34302) |
| 103TC0700X Psychologist, Clinical (Licence: TX 34302) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: TX 34302) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: TX 34302) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: TX 34302) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: TX 34302) | |
| 103TC1900X Psychologist, Counseling (Licence: TX 34302) | |
| 103TE1100X Psychologist, Exercise & Sports (Licence: TX 34302) | |
| 103TF0000X Psychologist, Family (Licence: TX 34302) | |
| 103TH0004X Psychologist, Health (Licence: TX 34302) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: TX 34302) | |
| 103TS0200X Psychologist, School (Licence: TX 34302) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 34302) | |
| 103TH0100X Psychologist, Health Service (Licence: TX 34302) | |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2026-02-05 |