| NPI | 1285262790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2024-03525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2024-03525) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-07-09 |