NPI | 1427272723 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY8965) |
Enumeration Date | 2007-04-11 |
Last Update Date | 2009-07-15 |