| NPI | 1942398383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 13253) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A91905) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD13524) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2023-11-18 |