NPI | 1487946539 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL ME 124276) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
Enumeration Date | 2011-05-09 |
Last Update Date | 2024-09-06 |