| NPI | 1255407045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01074131A) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 51443) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 31036) | |
| Enumeration Date | 2006-11-26 |
| Last Update Date | 2024-08-23 |