| NPI | 1396175410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NH 1616) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 9749) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2024-11-27 |