| NPI | 1477802320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0005552) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20043068A) |
| 103TC0700X Psychologist, Clinical (Licence: CO PSY..0005552) | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2022-03-24 |