| NPI | 1952569758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0068988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125049324) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2022-08-02 |