| NPI | 1730351370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY21206) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY21206) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY21206) | |
| 103TC1900X Psychologist Counseling (Licence: CA PSY21206) | |
| 103TP0814X Psychologist Psychoanalysis (Licence: CA PSY21206) | |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-03-24 |