| NPI | 1316443856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2020012909) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-47031) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 43012) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE CP558) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO CDR.0003607) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2026-01-30 |