| NPI | 1174740252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IN 20042068B) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20042068A) |
| 103T00000X Psychologist (Licence: OH P.07823) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2021-09-27 |