| NPI | 1174973317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 34151) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101289351) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-12913) | |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2026-05-03 |