| NPI | 1487974176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2014-02260) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2014-02260) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2024-02-13 |