NPI | 1891936662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA Psy4875) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA M8634) |
Enumeration Date | 2009-03-09 |
Last Update Date | 2009-03-09 |