NPI | 1265602361 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042702A) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IN 20042702A) |
Enumeration Date | 2008-03-04 |
Last Update Date | 2017-04-19 |