| NPI | 1447458708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: RI PS01024) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01024) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2013-02-05 |