| NPI | 1831184183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY18893) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: CA PSY18893) |
| 103TC0700X Psychologist Clinical (Licence: CA PSY18893) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: CA PSY18893) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2007-07-08 |