| NPI | 1326295387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 41931) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101243295) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 586) | |
| 2084P0805X (Licence: KS 04-34859) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2016-01-12 |