| NPI | 1104537570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043569B) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IN 20043569A) | |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2024-12-23 |