NPI | 1881094480 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OH 7191) |
103TC0700X Psychologist, Clinical (Licence: OH 7191) | |
103TC1900X Psychologist, Counseling (Licence: OH 7191) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 7191) | |
103TE1100X Psychologist, Exercise & Sports (Licence: OH 7191) | |
103TF0000X Psychologist, Family (Licence: OH 7191) | |
103TF0200X Psychologist, Forensic (Licence: OH 7191) | |
103TH0004X Psychologist, Health (Licence: OH 7191) | |
103TH0100X Psychologist, Health Service (Licence: OH 7191) | |
103TA0700X Psychologist, Adult Development & Aging (Licence: OH 7191) | |
Enumeration Date | 2014-09-02 |
Last Update Date | 2019-04-11 |