| NPI | 1841485836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NV 0530) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: NV 0530) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2023-09-20 |