| NPI | 1730530452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO204267) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA DO.OP.61630349) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125069151) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2026-09-30 |