| NPI | 1710484274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301505495) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301114494) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4351029091) | |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2023-11-02 |