| NPI | 1720575111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR e-16683) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 60084) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2024-10-03 |