| NPI | 1093088544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20043459A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35002124A) |
| 106H00000X Marriage & Family Therapist (Licence: MN 2674) | |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2022-03-04 |