NPI | 1346298866 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P2278) |
Additional Taxonomies | 103T00000X Psychologist (Licence: TN P2278) |
103TC0700X Psychologist, Clinical (Licence: ID PSY-202526) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN P2278) | |
103TH0100X Psychologist, Health Service (Licence: TN P2278) | |
Enumeration Date | 2006-05-05 |
Last Update Date | 2019-08-15 |