| NPI | 1073774238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2011019835) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-39077) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 94029) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2025-05-12 |