NPI | 1033149141 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY4461) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY4461) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2023-06-13 |