| NPI | 1326659012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01845) |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-11-30 |