| NPI | 1285605840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101238724) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101238724) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2026-02-19 |