| NPI | 1588634554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 84050) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA MD.13334R) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD.13334R) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2013-01930) | |
| 208D00000X General Practice (Licence: LA 13334R) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2023-07-11 |