| NPI | 1437550415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM PSY-RXC0081) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NM PSY1341) |
| 103G00000X Clinical Neuropsychologist (Licence: NM 1341) | |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2021-10-29 |