| NPI | 1891942561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: TN PE 614) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN LPC 155) |
| 103TS0200X Psychologist, School (Licence: TN ED 500274) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2008-08-25 |