| NPI | 1982648945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY 5909) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071-002737) |
| 103G00000X Clinical Neuropsychologist (Licence: MI 6301003363) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2007-08-10 |