| NPI | 1275986762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: LA 326427) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD468829) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2023-02-09 |