| NPI | 1407474257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043390A) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TH0100X Psychologist, Health Service | |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2024-10-23 |