| NPI | 1588629414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD41529) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 056431) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N2481) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2023-10-18 |