| NPI | 1184157810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO222402) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 2051) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2025-05-28 |