NPI | 1114567310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA Psy31555) |
Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: CA psy31555) |
Enumeration Date | 2020-01-15 |
Last Update Date | 2024-04-05 |