NPI | 1194750422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY18879) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY18879) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2024-07-15 |