| NPI | 1033266234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY 14788) | |
| 103TC1900X Psychologist, Counseling | |
| 103TF0000X Psychologist, Family | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |