| NPI | 1275580102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20041988A) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IN 20041988A) |
| 103TS0200X Psychologist, School (Licence: IN 20041988A) | |
| 103TC0700X Psychologist, Clinical (Licence: IN 20041988A) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2007-08-02 |