| NPI | 1275093254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 13141285-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT218016) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD474556) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT218016) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2023-04-03 |