| NPI | 1487708079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TN 15343) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 11528) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-08-01 |