| NPI | 1780100958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 73990) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 218873) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 65845) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 91977) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD213412) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101268565) | |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2024-07-01 |