| NPI | 1174620165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 4846) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 42433) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 057763) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-12-02 |