| NPI | 1023234770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: CA PSY10347) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY10347) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA PSY10347) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY10347) | |
| 103TC1900X Psychologist, Counseling (Licence: CA PSY10347) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY10347) | |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY10347) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSY10347) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSY10347) | |
| 106H00000X Marriage & Family Therapist (Licence: CA PSY10347) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |