| NPI | 1194749507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 13015) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: HI PSY-477) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2025-07-10 |