| NPI | 1639468465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 75910) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2016-0610) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M-14923) | |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2025-02-12 |