| NPI | 1023539475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY29850) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103G00000X Clinical Neuropsychologist (Licence: CA PSY29850) | |
| 103T00000X Psychologist | |
| 103TF0200X Psychologist, Forensic | |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY29850) | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2022-12-21 |