| NPI | 1760695290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-33055) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 203307) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T6078) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0070047) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2024-11-01 |