| NPI | 1295746014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OH 6196) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: OH 6196) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-07-03 |