NPI | 1174585202 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OH 3804) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OH 3804) |
Enumeration Date | 2006-04-04 |
Last Update Date | 2022-06-30 |