| NPI | 1548365463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME88058) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 047072) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 34907) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2009-06-11 |