| NPI | 1922102508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 19631) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 33149) |
| 208M00000X Hospitalist (Licence: WI 33149-20) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2018-03-17 |