| NPI | 1326168428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A17226) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 44338) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2022-08-23 |