| NPI | 1740385483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 45754) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.085695) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101242897) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2013-06-11 |