| NPI | 1639194566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 52844) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 17682) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 17682) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-07-13 |