| NPI | 1104944669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20041241A) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IN 20041241A) |
| 103TC0700X Psychologist, Clinical (Licence: IN 20041241A) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2025-09-11 |