| NPI | 1134224843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A101211) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-12408) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-12408) | |
| 207R00000X Internal Medicine (Licence: CA A101211) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2012-03-26 |