| NPI | 1710449418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2024034352) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SD 14538) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-09-11 |