| NPI | 1639174493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 0199) |
| Additional Taxonomies | 175L00000X Homeopath (Licence: AZ 0199) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 0199) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-05-27 |