| NPI | 1821352527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: RI PS01300) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: RI PS01300) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2019-10-03 |