| NPI | 1134738057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20043486B) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: IN 20043486A) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2022-06-21 |