| NPI | 1093816670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P0000002416) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TN 2416) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2024-11-18 |