NPI | 1184790560 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IA 00217) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IA 00631) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2010-12-15 |