NPI | 1891905436 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.008864) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301003853) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2020-10-30 |