| NPI | 1154437457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60731341) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101056839) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036147881) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 85333) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 64261) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 034783) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2023-01-18 |