| NPI | 1962807867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: MD 05665) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MD 05665) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2024-01-02 |