| NPI | 1093771107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 14995) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101241086) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD36657) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2025-03-12 |