| NPI | 1861771206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MO 2014031617) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071009269) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2022-02-10 |