NPI | 1396806030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 682MP) |
Additional Taxonomies | 103T00000X Psychologist (Licence: LA 682MP) |
103TC0700X Psychologist, Clinical (Licence: LA 682MP) | |
Enumeration Date | 2006-12-13 |
Last Update Date | 2013-08-02 |