| NPI | 1326015660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20040374A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20040374) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2010-10-28 |