NPI | 1497969133 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: LA 386) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 386) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2022-09-12 |