| NPI | 1215937826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: FL PY0004169) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: FL PY0004169) |
| 103G00000X Clinical Neuropsychologist (Licence: FL PY0004169) | |
| 103T00000X Psychologist (Licence: FL PY0004169) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2025-09-11 |