| NPI | 1548375058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01067588A) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301502715) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IN 01067588A) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.149699) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S9579) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 55347) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-03-28 |