| NPI | 1376848168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA psy7428) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: CA psy7428) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |