| NPI | 1952396863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 015147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 15147) |
| 207P00000X Emergency Medicine (Licence: IL 036-107861) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2024-11-13 |