NPI | 1578572947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AK 441) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AK 441) |
103TC0700X Psychologist, Clinical (Licence: AK 441) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AK 441) | |
103TF0200X Psychologist, Forensic (Licence: AK 441) | |
103TA0700X Psychologist, Adult Development & Aging (Licence: AK 441) | |
103T00000X Psychologist (Licence: AK 441) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: AK 441) | |
Enumeration Date | 2006-08-05 |
Last Update Date | 2012-03-22 |