| NPI | 1467931485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX V8085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V8085) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2025-06-27 |