| NPI | 1326264623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2008-0595) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NM MD2008-0595) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2008-0595) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-04-16 |