| NPI | 1063764090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY10872) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2012-10-15 |