| NPI | 1427671619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA R-11829) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 83168) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 83168) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA R-11829) | |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2025-11-26 |