NPI | 1568546422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 2671) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic |
Enumeration Date | 2006-10-25 |
Last Update Date | 2024-05-08 |