NPI | 1356350037 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OH 4429) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OH 4429) |
103TR0400X Psychologist, Rehabilitation (Licence: OH 4429) | |
Enumeration Date | 2006-08-05 |
Last Update Date | 2013-05-28 |