| NPI | 1669059697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T8818) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A23972) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0075136) | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-07-21 |