| NPI | 1841976388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: PR 6469) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PR 6469) |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2023-06-27 |