NPI | 1861524241 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MD 2415) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: VA 0810002498) |
103G00000X Clinical Neuropsychologist (Licence: DE B1-0001108) | |
Enumeration Date | 2007-03-12 |
Last Update Date | 2020-03-26 |