| NPI | 1316165079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101271672) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 28865) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 5086) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 9900934) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2024-02-23 |