| NPI | 1932318078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD154637) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 38004) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A111108) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2021-03-10 |