| NPI | 1588845697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q7062) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 16947) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2005-0190) | |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2024-11-14 |