| NPI | 1316244627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042500A) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: IN 20042500A) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20042500A) | |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2016-09-14 |