NPI | 1427001254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA 20796) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA 20796) |
Enumeration Date | 2006-05-19 |
Last Update Date | 2024-01-17 |