| NPI | 1326280223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61123092) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 249908) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD182417) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2022-07-21 |