| NPI | 1184997561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV CL0021) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS12123) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R2332) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 14828) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 006540) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS017394) | |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2021-08-18 |