| NPI | 1588698948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2005009921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2005009921) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-02-07 |