| NPI | 1346314838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: CA PSY16095) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY16095) |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY16095) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2009-03-20 |