| NPI | 1831223296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC DO034312) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD H70765) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102202604) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2021-11-18 |