| NPI | 1467534883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: WI 891-57) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 6039-120) |
| 103T00000X Psychologist (Licence: WI 891-057) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2023-11-16 |