| NPI | 1598962946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T9237) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI md-18234) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 59009) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2025-01-21 |