| NPI | 1578513230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-23035) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME119855) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-10-15 |