NPI | 1124215777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20043496A) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001667A) |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2007-09-27 |
Last Update Date | 2021-11-22 |