NPI | 1376548867 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: RI PS00813) |
103TC0700X Psychologist, Clinical (Licence: RI PS00813) | |
Enumeration Date | 2005-06-20 |
Last Update Date | 2022-07-19 |