NPI | 1750366902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301011373) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY14385) |
103T00000X Psychologist (Licence: MI 6301011373) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY14385) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301011373) | |
103TC0700X Psychologist, Clinical (Licence: CA PSY14385) | |
103TC0700X Psychologist, Clinical (Licence: MI 6301011373) | |
103TC1900X Psychologist, Counseling (Licence: CA PSY14385) | |
103TC1900X Psychologist, Counseling (Licence: MI 6301011373) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY14385) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301011373) | |
103T00000X Psychologist (Licence: CA PSY14385) | |
Enumeration Date | 2005-12-09 |
Last Update Date | 2007-07-08 |