| NPI | 1235759549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR DO218864) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR PG199038) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2024-10-28 |