NPI | 1013024744 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 6418) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: CA 6418) |
Enumeration Date | 2006-08-25 |
Last Update Date | 2025-07-14 |