NPI | 1477386118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY12242) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY12242) |
Enumeration Date | 2024-08-20 |
Last Update Date | 2024-10-15 |