| NPI | 1679574313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TN 64172) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: SD 4624) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2022-07-14 |