| NPI | 1174787436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20040316A) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: IN 20040316A) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2008-07-16 |