| NPI | 1306845250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TN P2402) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TN P2402) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2015-08-31 |