| NPI | 1457988800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KY 06100) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 06100) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-06-24 |