NPI | 1437620663 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NJ TP183-073) |
Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: NJ TP183-073) |
Enumeration Date | 2018-12-16 |
Last Update Date | 2018-12-16 |