| NPI | 1659669380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015379) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301015379) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301015379) | |
| 173F00000X Sleep Specialist, PhD (Licence: 6301015379) | |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2020-04-28 |