| NPI | 1437291168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA Psy21325) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA 21325) |
| 103T00000X Psychologist (Licence: CA 21325) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2021-11-15 |