| NPI | 1962073338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TN 4155) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810008866) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2025-09-17 |