| NPI | 1376652206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S5933) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 36379) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-36379) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-01-19 |