| NPI | 1821572389 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 38506) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IN 20043435A) |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2025-02-02 |