| NPI | 1760499933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2006-00885) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2006-00885) |
| 208VP0000X (Licence: NC 2006-00885) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-03-10 |