| NPI | 1699793315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20040005) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IN CO14) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-04-01 |