| 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 |