| NPI | 1184860181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: TN PE0000000649) |
| Additional Taxonomies | 103TS0200X Psychologist, School |
| Enumeration Date | 2008-12-21 |
| Last Update Date | 2008-12-21 |