| NPI | 1154342962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-19609) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 37129) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A49889) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-13 |