| NPI | 1972508471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20043298A) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: OH 5281) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-10-12 |