| NPI | 1417376393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 11236442-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA not yet assigned) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA not yet assigned) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2021-10-27 |