NPI | 1144557588 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TN P0000003336) |
Additional Taxonomies | 103T00000X Psychologist (Licence: AR 17-05P) |
Enumeration Date | 2009-11-05 |
Last Update Date | 2018-10-25 |