| NPI | 1972592798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IN 20042166) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: IL 071.007397) |
| 103TC0700X Psychologist, Clinical (Licence: IN 20042166A) | |
| 103TH0100X Psychologist, Health Service (Licence: IN 20042166A) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2023-06-30 |