| NPI | 1497490486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD.MD.70059850) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MDR-8288) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2026-06-17 |