| NPI | 1194855510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY21093) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: HI PSY-1532) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2026-04-17 |