| NPI | 1932195484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C145591) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 18668) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2008-01594) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD423085) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD171207) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2024-06-07 |