NPI | 1013246057 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY19830) |
Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60537543) |
Enumeration Date | 2009-12-22 |
Last Update Date | 2024-08-08 |