| NPI | 1881787943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS003744L) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PA PS003744L) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS003744L) | |
| 103TF0200X Psychologist, Forensic | |
| 174400000X Specialist | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-03-24 |