| NPI | 1356738348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 282103) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 264499) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 282103) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2024-12-30 |