| NPI | 1992812606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 00012918) |
| Additional Taxonomies | 2084P0805X (Licence: AL 00012918) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2023-11-29 |