| NPI | 1871668046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 4081) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 4081) |
| 103TF0000X Psychologist, Family (Licence: OH 4081) | |
| 103TH0100X Psychologist, Health Service (Licence: OH 4081) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2012-02-01 |