| NPI | 1477781870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY9474) |
| Additional Taxonomies | 103TP0814X Psychologist Psychoanalysis (Licence: CA PSY9474) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |