| NPI | 1861505059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IN LIC20090165A) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service |
| 103T00000X Psychologist | |
| 103TC1900X Psychologist Counseling (Licence: IN LIC20090165A) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2016-01-28 |