| NPI | 1447413471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 1714) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 1234) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2024-11-22 |