| NPI | 1568299659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NH 6847) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: NH 6847) |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-13 |