| NPI | 1851586937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OK 1175) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2016-02-19 |