| NPI | 1558507707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 50773) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 5803) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SD 8424) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2024-05-13 |