NPI | 1871587618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AL 854) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 854) |
Enumeration Date | 2005-09-08 |
Last Update Date | 2014-10-31 |