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 |