| NPI | 1740265578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01071532A) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 46816-020) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2019-04-25 |