| NPI | 1467606616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61573411) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 57260-20) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME155724) | |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2024-08-08 |