| NPI | 1356847511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 65718) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T1871) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 318115) | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2022-09-30 |