| NPI | 1497967897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 34531) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101045229) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G61701) | |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2007-07-09 |