| NPI | 1538120126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 27334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 30090) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 30090) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: KY 30090) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2023-04-27 |