| NPI | 1457556656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 52993) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 53596) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 31456) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 105171) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2024-01-16 |