| NPI | 1841269974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: LA 381MP) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 381MP) |
| 103TF0000X Psychologist, Family (Licence: LA 381MP) | |
| 103TF0200X Psychologist, Forensic (Licence: LA 381MP) | |
| 103TH0100X Psychologist, Health Service (Licence: LA 381MP) | |
| 103T00000X Psychologist (Licence: LA 381MP) | |
| 103TS0200X Psychologist, School (Licence: LA 381MP) | |
| 103TC0700X Psychologist, Clinical (Licence: LA 381MP) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |