| NPI | 1417410671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U4642) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ R77345) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01096351A) | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2026-03-27 |