| NPI | 1881126852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-50112) |
| Additional Taxonomies | 2084H0002X Psychiatry & Neurology, Hospice and Palliative Medicine (Licence: IA MD-50112) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: IA MD-50112) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD-50112) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2025-10-24 |