NPI | 1205040961 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: CA PSY 17557) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling |
Enumeration Date | 2007-05-10 |
Last Update Date | 2016-12-12 |