| NPI | 1134241227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20042066A) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2010-11-02 |