| NPI | 1225231426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY7245) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY7245) |
| 103TF0000X Psychologist, Family (Licence: CA PSY7245) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 7775) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2025-09-11 |