| NPI | 1588756704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY 20276) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 20276) |
| 103TF0200X Psychologist, Forensic (Licence: CA PSY 20276) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2013-05-03 |