NPI | 1104944669 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20041241A) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IN 20041241A) |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: IN 20041241A) | |
Enumeration Date | 2007-03-26 |
Last Update Date | 2007-07-08 |