NPI | 1538404116 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: WA PY60324969) |
Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60324969) |
Enumeration Date | 2012-12-07 |
Last Update Date | 2015-02-19 |