| NPI | 1699733113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD16538) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN MD16538) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 251454) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-10-10 |