NPI | 1679913586 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C181399) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 288021) | |
Enumeration Date | 2013-06-25 |
Last Update Date | 2024-03-05 |