| NPI | 1386634814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041915A) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IN 20041915A) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20041915A) | |
| 103T00000X Psychologist (Licence: IN 20041915A) | |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810003469) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2016-05-16 |