| NPI | 1134896137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NH 1572) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2025-08-05 |