| NPI | 1023425618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: IN 39001528A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 39001528A) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-07-16 |