Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0004X | Health Psychologist | A73307 | CA |
NPI | 1487874053 |
---|---|
Provider Name | Dr. Robert Gaffney |
First Address | Tahoe City, CA 96145 |
Second Address | Olympic Valley, CA 96146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |