| NPI | 1740587559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20043441A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39002197A) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2021-02-23 |