NPI | 1992913198 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS-004175-L) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PA PS004175-L) |
103T00000X Psychologist (Licence: NJ 1838) | |
103T00000X Psychologist (Licence: NY 010299) | |
Enumeration Date | 2007-05-19 |
Last Update Date | 2010-11-29 |