| NPI | 1437604667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 35651) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 35651) |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY35651) | |
| 103G00000X Clinical Neuropsychologist (Licence: CA PSY35651) | |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2025-09-29 |