| NPI | 1477844314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AR 11-24P) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AR 10-14 AP-PL) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2025-03-12 |