| NPI | 1326259631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 45881) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2016-01872) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R6173) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2022-07-29 |