| NPI | 1851840656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NV PY0790) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NV PY0790) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NV PY0790) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NV PY0790) | |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2023-09-28 |