| NPI | 1083644546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IN 20042356A) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: NJ 35SI00157600) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2015-08-18 |