| NPI | 1841874161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 38424) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OK 38424) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2024-09-17 |