| NPI | 1649140112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20044062A) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: IN 20044062A) |
| Enumeration Date | 2025-11-10 |
| Last Update Date | 2026-03-24 |