| NPI | 1306226881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A25629) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 02005251A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 279138) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2026-09-16 |