| NPI | 1528142163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: IN 20040890A) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IN 20040890A) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2025-04-29 |