NPI | 1427541549 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OH 07707) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OH 07707) |
Enumeration Date | 2018-06-13 |
Last Update Date | 2018-09-04 |