| NPI | 1508217928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2020-0322) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM RS2016-0466) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2023-09-22 |