NPI | 1093962185 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA psy26343) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
Enumeration Date | 2008-08-20 |
Last Update Date | 2015-02-09 |