NPI | 1073670055 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY00003486) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WA PY00003486) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2024-06-07 |