| NPI | 1366635518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20041132A) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2024-01-31 |