| NPI | 1841494499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| 246ZB0600X Specialist/Technologist, Other, Biostatistician | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2012-03-02 |