| NPI | 1821822776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NH 6841) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NH 6841) |
| 103TH0100X Psychologist Health Service (Licence: NH 6841) | |
| Enumeration Date | 2024-08-30 |
| Last Update Date | 2024-09-17 |