| NPI | 1215961651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 36581) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 51064) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 9600464) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A051148) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-09-08 |