| NPI | 1407058290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 10954) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 31730) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2019-07-11 |