NPI | 1780892166 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NJ 35SI00409100) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PA PS015223) |
Enumeration Date | 2007-05-18 |
Last Update Date | 2010-12-28 |