| NPI | 1376565796 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation (Licence: IN 20010382A)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20010282A)  | 
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: IN 20010382A)  | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: IN 20010382A)  | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IN 20010382A)  | |
| 103TC0700X Psychologist, Clinical (Licence: IN 20010382A)  | |
| 103TF0000X Psychologist, Family (Licence: IN 20010382A)  | |
| 103TH0100X Psychologist, Health Service (Licence: IN 20010382A)  | |
| 103T00000X Psychologist (Licence: IN 20010382A)  | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: IN 20010382A)  | |
| Enumeration Date | 2006-07-24 | 
| Last Update Date | 2025-09-11 |