NPI | 1194927855 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA PSY25375) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA 25375) |
103TC0700X Psychologist, Clinical (Licence: CA PSY25375) | |
Enumeration Date | 2007-06-04 |
Last Update Date | 2024-04-27 |