| NPI | 1588098545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OK 1280) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 2102) |
| 103G00000X Clinical Neuropsychologist (Licence: KS 2102) | |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2026-08-11 |