NPI | 1447488127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY19475) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA PSY19475) |
103TH0004X Psychologist, Health (Licence: CA PSY19475) | |
103TR0400X Psychologist, Rehabilitation (Licence: CA PSY19475) | |
Enumeration Date | 2009-07-01 |
Last Update Date | 2022-07-21 |