| NPI | 1225327877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: CA RP018) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: RP018) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-12 |