| NPI | 1346303161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NJ 35SI00232100) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NJ S102321) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2018-11-05 |