| NPI | 1790887669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20040651A) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: IN 20040651A) |
| 103TC0700X Psychologist, Clinical (Licence: IN 20040651A) | |
| 103TC1900X Psychologist, Counseling (Licence: IN 20040651A) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20040651A) | |
| 103TF0200X Psychologist, Forensic (Licence: IN 20040651A) | |
| 103TH0100X Psychologist, Health Service (Licence: IN 20040651A) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IN 20040651A) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: IN 20040651A) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: IN 20040651A) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2024-04-19 |