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 |