| NPI | 1184891277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2018-00550) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101255945) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 1021842) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2026-04-30 |