| NPI | 1174909824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: CA PSY 8334) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY 8334) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2026-06-16 |