NPI | 1588864615 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NC 0906) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 0906) |
Enumeration Date | 2007-07-18 |
Last Update Date | 2014-06-16 |