| NPI | 1841452919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA DO-06395) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MN 56928) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA OS017907) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MT200309) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2023-08-30 |