| NPI | 1336282524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS008377L) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2022-07-21 |