| NPI | 1447742895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH P.08229) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2023-08-08 |