| NPI | 1437756186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 290060) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2020011200) |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2021-07-14 |