| NPI | 1366760043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-18117) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61085628) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2023-03-22 |