| NPI | 1871693713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0013025) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 13177) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01018132A) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-08 |