| NPI | 1912437245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101026629) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5151013371) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101023378) | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |