| NPI | 1619201241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 59008) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 264961) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A109408) | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2022-05-06 |