| NPI | 1467972000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NC 6049) |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2022-09-22 |