NPI | 1235270851 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 24379) |
Additional Taxonomies | 103T00000X Psychologist |
103TC0700X Psychologist, Clinical (Licence: CA PSY24379) | |
Enumeration Date | 2007-02-08 |
Last Update Date | 2018-03-02 |