| NPI | 1154354629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD166314) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A96061) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD452028) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2023-04-07 |