| NPI | 1962665760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY22399) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 22399) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2024-02-02 |