| NPI | 1871749242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A138432) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 275013) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q0145) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2008012449) | |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2025-11-10 |