| NPI | 1447327739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 24738) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 25340) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-12-30 |