| NPI | 1710168976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: IN 20041896A) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: UT 7102951-2501) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2023-01-24 |