| NPI | 1487819744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101251696) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0027303) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25IA12339600) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R5792) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 47582) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2025-06-03 |