| NPI | 1902677867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: AL 2341) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AL 2341) |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |