| NPI | 1912965476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY7553) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY7553) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2025-09-11 |