| NPI | 1225506900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY28063) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY28063) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY28063) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSY28063) | |
| Enumeration Date | 2018-11-11 |
| Last Update Date | 2018-11-11 |