| NPI | 1932118809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA PS005231L) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: PA PS005231L) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2013-04-03 |