NPI | 1801920277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY14959) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY14959) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2021-04-22 |