NPI | 1356481378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TN P10000001007) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN P10000001007) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN P10000001007) | |
103TF0000X Psychologist, Family (Licence: TN P10000001007) | |
Enumeration Date | 2007-02-07 |
Last Update Date | 2007-07-08 |