| NPI | 1306096714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 26148) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC44634) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2023-12-06 |