| NPI | 1073762928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY22018) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY22018) |
| 103T00000X Psychologist (Licence: CA PSY22018) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: CA PSY22018) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY22018) | |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2023-01-22 |