| NPI | 1538044086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043955A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 296065) |
| Enumeration Date | 2025-08-06 |
| Last Update Date | 2025-09-24 |