NPI | 1881848026 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: CA psy12880) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA psy12880) |
Enumeration Date | 2008-11-14 |
Last Update Date | 2024-08-17 |