| NPI | 1558545921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY3343) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY3343) |
| 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSY3343) | |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2008-03-17 |