NPI | 1003386608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZE0500X Specialist/Technologist, Other, EEG |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 90683) |
Enumeration Date | 2018-11-27 |
Last Update Date | 2018-12-06 |