| 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 |