NPI | 1528142163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20040890A) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: IN 20040890A) |
Enumeration Date | 2006-10-24 |
Last Update Date | 2008-01-11 |