| NPI | 1699138479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 51927) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 25116) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: AL 51927) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2026-05-01 |