| NPI | 1639215288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH T0980) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME53640) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-5658) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-04-05 |