| NPI | 1619941846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2007029603) |
| Additional Taxonomies | 2084P0805X (Licence: MO 2007029603) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2025-04-17 |