NPI | 1952101263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSB94025488) |
Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: CA PSB94025488) |
Enumeration Date | 2025-03-17 |
Last Update Date | 2025-07-10 |