| NPI | 1063481430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041670A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20041670A) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2020-06-15 |