| NPI | 1114449949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: WI 3497) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071-009517) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2023-11-08 |