| NPI | 1871783522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN DO2051) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 1096) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2021-10-06 |