| NPI | 1457387466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20040385) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IN 20040385) |
| 103TH0100X Psychologist Health Service (Licence: IN 20040385) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-11-25 |