| NPI | 1972640928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD MAITZ Treasurer 215-735-2505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA 004599L) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2010-10-05 |