| NPI | 1912073529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSY20961) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY20961) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2022-03-18 |