NPI | 1831278910 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: WA 60934231) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA 26796) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2023-06-30 |