| NPI | 1013246057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY19830) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60537543) |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2024-08-08 |