NPI | 1134220247 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY9978) |
Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSY9978) |
103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSY9978) | |
Enumeration Date | 2006-09-25 |
Last Update Date | 2021-01-28 |