NPI | 1417961087 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 23191) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS008354L) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2011-10-21 |