NPI | 1255189445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: CA PSY15694) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY15694) |
Enumeration Date | 2024-05-11 |
Last Update Date | 2024-05-11 |