| NPI | 1720009541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01087461A) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35 063221) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R0962) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-05-16 |