| NPI | 1013246628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 21331) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: CA 21331) |
| 103TP0814X Psychologist, Psychoanalysis (Licence: CA 21331) | |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2021-06-21 |