| NPI | 1316300866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 30838) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX V4407) |
| 208D00000X General Practice (Licence: NE 30838) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-10-28 |