| 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 |