| NPI | 1134336563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 42576) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: TN 517) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 517) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101241538) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2017-02-13 |