| NPI | 1790059194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101280860) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A163795) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 71519) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD478192) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 27001) | |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2024-07-01 |