| NPI | 1629051040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D72416) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01059034A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 42017) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2019-08-22 |