| NPI | 1619992757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042470A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001777A) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-04-18 |