| NPI | 1700045416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 45937) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 76056) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 251696) | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2023-09-06 |