| NPI | 1669458030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX J8824) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX J8824) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2023-01-13 |