| NPI | 1891726071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NJ 3659) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PA PS-008682-L) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-05-14 |