| NPI | 1023432150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: CA PSY9999) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: WA PY60043174) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2014-02-10 |