| NPI | 1851400121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 34087) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 8998) |
| 208M00000X Hospitalist (Licence: IA MD-34087) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-10-25 |