| NPI | 1639246739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 42755) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 20354) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 40512) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2018-06-18 |