| NPI | 1588285159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: DE B1-0011432) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1780) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2025-08-28 |