| NPI | 1356316434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IN 20040552A) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: IN 20040552A) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: IN 20040552A) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-11-27 |