NPI | 1679611750 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A023530) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA A023530) |
Enumeration Date | 2007-02-02 |
Last Update Date | 2009-09-21 |