NPI | 1144293994 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS005182L) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PA PS005182L) |
Enumeration Date | 2006-02-10 |
Last Update Date | 2017-06-02 |