| NPI | 1538196126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC M040999) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD 1036331) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101255090) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2025-01-17 |