| NPI | 1750349601 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 10096) | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH RT-2548) | 
| Enumeration Date | 2006-05-02 | 
| Last Update Date | 2021-06-04 |