NPI | 1740316736 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IN 20010315A) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20010315A) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2007-07-08 |