NPI | 1356474092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 12676) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071007843) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2023-06-14 |