| NPI | 1275858037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY31352) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 103T00000X Psychologist (Licence: FL PY00004849) | |
| 103T00000X Psychologist (Licence: FL PY0004849) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY31352) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY0004849) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2023-02-08 |