| NPI | 1174973317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS T-5141) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-12913) |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2024-06-25 |