| NPI | 1548403827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD446481) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 75688) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q5846) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 113339) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2023-12-14 |