| NPI | 1811213523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 16581) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GU emtl-2020-023) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2021-05-12 |