| NPI | 1073764577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101279226) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01070541A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME142635) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2024-04-19 |