| NPI | 1770642134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA CP15744) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CA cp15744) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA cp15744) | |
| 103TC0700X Psychologist, Clinical (Licence: CA cp15744) | |
| 103TC1900X Psychologist, Counseling (Licence: CA cp15744) | |
| 103T00000X Psychologist (Licence: CA cp15744) | |
| 103TH0100X Psychologist, Health Service (Licence: CA cp15744) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: CA cp15744) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA cp15744) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: CA cp15744) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |