| NPI | 1366648230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-18432) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MP 504) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2010-0144) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2023-01-26 |