| NPI | 1790800910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20040843) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: IN 20040843) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2009-04-09 |