| NPI | 1871674465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: HI 315) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI PSY315) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2024-06-11 |