| NPI | 1518095728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD28601) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD28601) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0068847) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM 2004-0270) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2022-07-01 |