| NPI | 1508941204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61413485) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD d0052816) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01077111A) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2026-03-13 |