| NPI | 1104537570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IN 20043569A) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2024-03-18 |