| NPI | 1760579585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 6626833-1205) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01079485A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60662872) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-43999) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2024-04-26 |