NPI | 1053514281 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CO 2309) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 22735) |
Enumeration Date | 2007-06-06 |
Last Update Date | 2007-07-08 |