| NPI | 1780857821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0067420) |
| Additional Taxonomies | 2084P0805X (Licence: NM MD2011-0543) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2011-0543) | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2021-10-19 |