| NPI | 1316001514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY9509) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY9509) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY9509) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY9509) | |
| 103TH0100X Psychologist, Health Service (Licence: CA PSY9509) | |
| 103T00000X Psychologist (Licence: CA PSY9509) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSY9509) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2012-10-31 |