| NPI | 1982907424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY32156) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 018694) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2024-05-29 |