| NPI | 1134271943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY16884) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY16884) |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY16884) | |
| 103T00000X Psychologist (Licence: CA PSY166) | |
| 103TC1900X Psychologist, Counseling (Licence: CA PSY16884) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY16884) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2023-11-16 |