| NPI | 1679824239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101267671) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MTL003899) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D89868) | |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2021-06-11 |