| NPI | 1033572573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 10483203-1205) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD198305) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2022-10-31 |