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 |