| NPI | 1467532424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TN 1761) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN 1761) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2008-04-17 |