| NPI | 1093793705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 296278) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2023-12-21 |