NPI | 1386711984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: IN 2004-1203A) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OH 5386) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2016-01-14 |