| NPI | 1902940273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY15184) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: CA PSY15184) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2007-07-08 |