| NPI | 1467464313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OH 6229) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6229) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: OH 6229) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: OH 6229) | |
| 103G00000X Clinical Neuropsychologist (Licence: OH 6229) | |
| 103T00000X Psychologist (Licence: OH 6229) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2023-07-18 |