| NPI | 1972920783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20043204A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: LA 1257) |
| 103T00000X Psychologist (Licence: IN 20043204A) | |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2020-03-03 |