NPI | 1013230036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: CA MFC32601) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2010-03-04 |
Last Update Date | 2010-03-04 |