| NPI | 1003898495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 64665) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 102804) |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2022-02-24 |