| NPI | 1730282070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 65450) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME124968) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SD rl0412) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2022-10-10 |