| NPI | 1033326459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: CA PSY13655) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY13655) |
| 103T00000X Psychologist (Licence: CA PSY13655) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY13655) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY13655) | |
| 103TC1900X Psychologist, Counseling (Licence: CA PSY13655) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY13655) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY13655) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSY13655) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: CA PSY13655) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2025-09-11 |