| NPI | 1063186831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20043730A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 107642) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2023-10-30 |