NPI | 1306007802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY9655) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY9655) |
Enumeration Date | 2008-06-18 |
Last Update Date | 2008-06-18 |