| NPI | 1225144967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY15081) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 15081) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-09-29 |