| NPI | 1063820637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042943A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 1292) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2025-07-25 |