| NPI | 1497978258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD0000041286) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 21766) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD199956) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 15513) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2024-01-10 |