| NPI | 1093249161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 63529) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 54821) |
| 2084P0805X (Licence: TN 63529) | |
| Enumeration Date | 2017-04-16 |
| Last Update Date | 2025-05-07 |