| NPI | 1427587914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U3738) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01085533A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.168944) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI EMC0004490) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.137331) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-06-04 |