| NPI | 1952696395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD60852436) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101252360) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2025-08-27 |