| NPI | 1891952255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NH 8970) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NH 4138) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2015-12-03 |