| NPI | 1427448893 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 55623) | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MTL002309) | 
| Enumeration Date | 2015-01-23 | 
| Last Update Date | 2023-08-07 |