| NPI | 1053680033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: WI 2993-57) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 2993) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2021-02-09 |