| NPI | 1598012528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 28976) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 028976) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 28976) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2021-09-17 |