| NPI | 1033543772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NM MD2017-0877) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NM RS2013-0739) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2023-12-04 |