| NPI | 1730613175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WI 81140-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: DC 210002290) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101275570) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 294714) | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2023-04-04 |