| NPI | 1356442636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TN PE1618) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN 1618) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2024-09-14 |