NPI | 1609110808 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TN 3250) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MO 2012029768) |
Enumeration Date | 2012-11-12 |
Last Update Date | 2022-03-29 |