NPI | 1306889795 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A22430) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA a22430) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2008-02-11 |