| NPI | 1629955406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20040717) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071004523) |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-21 |