| 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 |