| NPI | 1518947506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-15926) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2002010580) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 0529682) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2023-01-20 |