NPI | 1265414445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS007009L) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PA PS007009L) |
Enumeration Date | 2005-11-15 |
Last Update Date | 2018-10-09 |