| NPI | 1528032075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA PS003079L) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS003079L) |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2007-07-26 |