| NPI | 1447711692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 42045) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL TPME8001) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-17851) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-10-24 |