| NPI | 1083925945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q4867) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q4867) |
| 207R00000X Internal Medicine (Licence: IL 125.058546) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125.058546) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2024-11-14 |