| NPI | 1902836372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301015194) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071004082) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-02-25 |