| NPI | 1497593289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: ME PS2601) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0006370) |
| 103TC0700X Psychologist, Clinical (Licence: ME PS2601) | |
| 103G00000X Clinical Neuropsychologist (Licence: CO PSY.0006370) | |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2024-08-16 |