NPI | 1245245117 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CO 2846) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301006649) |
Enumeration Date | 2006-07-29 |
Last Update Date | 2009-11-10 |