| NPI | 1295172849 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CT 3337) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: RI PS01368) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2022-07-08 |