| NPI | 1497215560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U2917) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-25518) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-06-30 |