| NPI | 1346056884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY35734) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY35734) |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2025-08-13 |