| NPI | 1437948387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: NE H13888962) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: NE H13888962) |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-05-06 |