NPI | 1235257502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY21283) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY21283) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2018-03-17 |