| NPI | 1235591512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101281371) |
| Additional Taxonomies | 208D00000X General Practice (Licence: RI MD16471) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2024-08-06 |