| NPI | 1386842789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA PS-0009266-L) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: DE B1-0000683) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2007-07-08 |