| NPI | 1235577164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME121067) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.144963) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 43516) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2024-10-23 |