| NPI | 1710480025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 91652) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IA MD-46729) |
| 208D00000X General Practice (Licence: GA 91652) | |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2022-06-24 |