| NPI | 1518076892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20041624A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20041624A) |
| 103TC0700X Psychologist Clinical (Licence: IN 20041624A) | |
| 103TE1100X Psychologist Exercise & Sports (Licence: IN 20041624A) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-03-07 |