| NPI | 1659589885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20041487) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20041487) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: IN 20041487) | |
| 103TC0700X Psychologist, Clinical (Licence: IN 20041487) | |
| 103TF0200X Psychologist, Forensic (Licence: IN 20041487) | |
| 103TH0004X Psychologist, Health (Licence: IN 20041487) | |
| 103TH0100X Psychologist, Health Service (Licence: IN 20041487) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: IN 20041487) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2020-03-19 |