| NPI | 1336308220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 39167) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX q4671) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 276429) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2023-02-07 |