| NPI | 1508803164 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0600X (Licence: IN 20041914A) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20041914A) | 
| 2084N0600X (Licence: IN 20041914) | |
| Enumeration Date | 2006-06-01 | 
| Last Update Date | 2025-02-15 |