| NPI | 1316977069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis (Licence: CA 38080) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 38080) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |