| NPI | 1437230760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY002943) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20041664A) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |