| NPI | 1437223245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY20560) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY20560) |
| 103TF0000X Psychologist, Family (Licence: CA PSY20560) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2010-05-19 |