| NPI | 1245425081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 19531) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: CA 19531) |
| 103TF0200X Psychologist, Forensic (Licence: CA 19531) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: CA 19531) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2007-09-13 |