| NPI | 1518926476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042164A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001531A) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2019-12-11 |