| NPI | 1134546237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IN 200403338A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 200403338A) |
| 103TH0004X Psychologist Health (Licence: IN 200403338A) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2021-03-22 |