| NPI | 1285746974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P4982) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 6685) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP70085739) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY C5013) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV CL0973) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102210024) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2026-05-14 |