NPI | 1285955948 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 31543) |
Additional Taxonomies | 103T00000X Psychologist (Licence: TX 31543) |
Enumeration Date | 2010-06-17 |
Last Update Date | 2025-08-27 |