| NPI | 1922509074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2019037704) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP61587191) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK 8775) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 011285) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-16311) | |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2024-10-09 |