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 |