| NPI | 1336119346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: DE B1 0000441) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PA PS 004797-L) |
| 103TC0700X Psychologist, Clinical (Licence: DE B1 0000441) | |
| 103TC0700X Psychologist, Clinical (Licence: PA PS 004797-L) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2018-04-30 |