| NPI | 1538723234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043656A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY13067) |
| 103TH0100X Psychologist, Health Service (Licence: IN 20043656B) | |
| Enumeration Date | 2019-04-28 |
| Last Update Date | 2026-08-06 |