| NPI | 1366506149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 18005) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 6930) |
| 2084P0805X (Licence: NH 18005) | |
| 2084P0805X (Licence: AK 6930) | |
| 208D00000X General Practice (Licence: AK 6930) | |
| 208D00000X General Practice (Licence: NH 18005) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2024-11-28 |