NPI | 1770517252 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA psy11012) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA psy11012) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2007-07-08 |