| NPI | 1396942264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.151601) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01066091A) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2025-06-06 |