NPI | 1093365736 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY31171) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY31171) |
103TA0700X Psychologist Adult Development & Aging (Licence: CA PSY31171) | |
103TC0700X Psychologist Clinical (Licence: CA PSY31171) | |
103TH0004X Psychologist Health (Licence: CA PSY31171) | |
Enumeration Date | 2019-09-15 |
Last Update Date | 2024-09-04 |