| NPI | 1336360874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2007-00815) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01095213A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2025000369) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2025-05-12 |