| NPI | 1487895736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY13156) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 13156) |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY 13156) | |
| 103TH0004X Psychologist, Health (Licence: CA PSY 13156) | |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2023-06-30 |