| NPI | 1265531396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A29528) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA A29528) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-10-05 |