| NPI | 1386900561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA Md.302187) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S5092) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C170655) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 307636) | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2020-11-20 |