| NPI | 1750415485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 83249) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 53913) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101267754) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-03-26 |