| NPI | 1760455133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2014-02539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2014-02539) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2014-02539) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2023-12-18 |