| NPI | 1386177228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME161728) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D91456) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U9597) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2024-10-16 |