| NPI | 1740591965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IN 20043169A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IN 39002708A) |
| 101YP2500X Counselor, Professional (Licence: IL 180009423) | |
| 103G00000X Clinical Neuropsychologist (Licence: IN 20043169A) | |
| 103TC0700X Psychologist, Clinical (Licence: IN 20043169A) | |
| 103TF0200X Psychologist, Forensic (Licence: IN 20043169A) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2018-08-06 |