| NPI | 1679723845 |
|---|---|
| Former Name | BRAD WALTER LARSEN SANCHEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2269) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 2269) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2023-07-12 |