| NPI | 1447989660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AL 2426) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CO PSY.0005780) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2025-06-20 |