| NPI | 1194837336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 186554) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 9701761) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 26381020) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-12-19 |