NPI | 1659456903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OH 1228) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH P.1228) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2022-01-04 |