| NPI | 1023296886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AR 13-38EI) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR P1007053) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2023-09-28 |