| NPI | 1790942571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AL MD22228) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 044472) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL MD22228) | |
| 208VP0000X (Licence: AL MD22228) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2025-04-03 |