| NPI | 1043407497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P4023) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P4023) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2016-11-29 |