| NPI | 1902186737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A130015) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 273208) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 37024) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2024-09-26 |