| NPI | 1811637002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SD 18662) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND PT24533) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 82361) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01100170A) | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2026-07-14 |