| NPI | 1760826218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 167199) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D95916) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101270253) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U0725) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2025-04-18 |