| NPI | 1518161082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI DO-1234) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI DO-1234) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2019-01-04 |