NPI | 1841226297 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301001732) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301001732) |
Enumeration Date | 2006-06-25 |
Last Update Date | 2007-07-09 |