| NPI | 1366910572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 024949) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071.009843) |
| 103G00000X Clinical Neuropsychologist (Licence: MO 2018033374) | |
| 103TC0700X Psychologist, Clinical (Licence: MO 2018033374) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071.009843) | |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2023-07-06 |