| NPI | 1417986795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101266623) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2006-00572) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2006-00572) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-08-11 |