| NPI | 1881846905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: KS 2040) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MO 2010017632) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2023-06-06 |