| NPI | 1679513527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI md4115) |
| Additional Taxonomies | 2084H0002X (Licence: HI MD4115) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: HI MD4115) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2024-08-02 |