| NPI | 1336657899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744R1102X Specialist, Research Study |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 174H00000X Health Educator | |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2023-09-14 |