| NPI | 1184827073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA CP8492) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: CA CP8492) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2025-09-11 |