| NPI | 1558421255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY21335) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY21335) |
| 103T00000X Psychologist (Licence: CA PSY21335) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY21335) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2024-04-27 |