| NPI | 1922595990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS18828) |
| Additional Taxonomies | 2084P0805X (Licence: FL OS18828) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2026-07-30 |