| NPI | 1336122928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IN 20041728A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20041728A) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2024-06-11 |