| NPI | 1609217611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2017-02587) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD182758) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE TEP7103) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60740000) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2023-04-27 |