| NPI | 1932399938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 20082) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: CA PSY 20082) |
| 103G00000X Clinical Neuropsychologist (Licence: CA PSY 20082) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2007-10-18 |