| NPI | 1386893618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY16148) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TA0700X Psychologist Adult Development & Aging | |
| 103TH0100X Psychologist Health Service | |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2008-09-10 |