| NPI | 1497703748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH P.08056) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: HI PSY 853) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-10-24 |