| NPI | 1427317825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS13796) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P7812) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 90434) | |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2025-05-13 |