| NPI | 1144218744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: DE B1-0000236) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NJ 35SI00183900) |
| 103G00000X Clinical Neuropsychologist (Licence: PA ps003678L) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2007-07-08 |