| NPI | 1346986775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD495501) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MTL500001830) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT236056) | |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2026-06-24 |