| NPI | 1205251006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 91718) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 91718) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2023-08-10 |