| NPI | 1831213834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TN 2423) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: TN 2423) |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2008-11-20 |