| NPI | 1982386751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20053875B) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20043875A) |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2024-11-04 |