| NPI | 1699975417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20042925A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 130398) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2024-08-16 |