| NPI | 1568690923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 2441) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 2981) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: KS 035) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: KS 2441) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: KS 2441) | |
| 103TF0000X Psychologist Family | |
| 103TF0200X Psychologist Forensic | |
| 103TH0004X Psychologist Health | |
| 103TP0814X Psychologist Psychoanalysis (Licence: KS 2441) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: KS 2441) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2021-04-20 |