NPI | 1194031203 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 17654) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.005036) |
Enumeration Date | 2010-08-26 |
Last Update Date | 2024-09-12 |