NPI | 1003197856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20043418A) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071.010299) |
103TC0700X Psychologist, Clinical (Licence: IL 071.010299) | |
103TC0700X Psychologist, Clinical (Licence: IN 20043418A) | |
Enumeration Date | 2011-09-07 |
Last Update Date | 2020-11-05 |