NPI | 1396986402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY00003771) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA 00003771) |
Enumeration Date | 2009-03-19 |
Last Update Date | 2024-11-06 |