| NPI | 1184717027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY6326) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: AL 1138) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-07-19 |