| NPI | 1801027578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NV PY0637) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY24361) |
| 103T00000X Psychologist (Licence: NV PY0637) | |
| 103G00000X Clinical Neuropsychologist (Licence: CA PSY24361) | |
| 103TC0700X Psychologist Clinical (Licence: CA PSY24361) | |
| 103TC0700X Psychologist Clinical (Licence: NV PY0637) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY24361) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NV PY0637) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY24361) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NV PY0637) | |
| 103TF0200X Psychologist Forensic (Licence: CA PSY24361) | |
| 103TF0200X Psychologist Forensic (Licence: NV PY0637) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: CA PSY24361) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NV PY0637) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2016-03-28 |