| NPI | 1407729353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043091A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810009134) |
| Enumeration Date | 2025-09-26 |
| Last Update Date | 2025-10-29 |