NPI | 1114081577 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY2226) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: WA PY2226) |
Enumeration Date | 2006-12-20 |
Last Update Date | 2007-07-09 |