NPI | 1578736021 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PYS7760) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA PSY7760) |
Enumeration Date | 2008-04-04 |
Last Update Date | 2016-07-07 |