| NPI | 1538690995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME165983) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036159195) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI T8967) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI 6978320) | |
| 208D00000X General Practice (Licence: WI 6978320) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-06-10 |