| NPI | 1740664689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0067803) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS15736) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 64316) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 02006535A) | |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2023-06-28 |