| NPI | 1144541376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR PG151476) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO157214) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV DO2575) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A15429) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2023-05-09 |