| NPI | 1295814150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY8833) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 93-261633-2501) |
| 103G00000X Clinical Neuropsychologist (Licence: UT 93-261633-2501) | |
| 103G00000X Clinical Neuropsychologist (Licence: CA PSY8833) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |