| NPI | 1225392996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q7069) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2020005837) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 35348) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-12818) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0014644) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 265074) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01083398A) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2020-03-10 |