| NPI | 1427581966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101265891) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101265891) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-06-25 |