| NPI | 1902953797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD050768L) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: TN 34743) |
| 207Y00000X Otolaryngology (Licence: TN 34743) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 34743) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2021-10-05 |