| NPI | 1932318672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS22431) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: CA LCS22431) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2009-03-19 |