| NPI | 1851272322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NV PY1257) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA 35429) |
| 103T00000X Psychologist (Licence: NV PY1257) | |
| 103T00000X Psychologist (Licence: CA 35429) | |
| 103TF0200X Psychologist, Forensic (Licence: NV PY1257) | |
| 103TF0200X Psychologist, Forensic (Licence: CA 35429) | |
| 103TH0100X Psychologist, Health Service (Licence: NV PY1257) | |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |