| NPI | 1588534432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TF0000X Psychologist, Family (Licence: CA 1234) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 5894) |
| 103TS0200X Psychologist, School (Licence: CA 987456A) | |
| Enumeration Date | 2025-11-06 |
| Last Update Date | 2025-11-06 |