| NPI | 1962466110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0052781) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C169635) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101235334) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2026-03-20 |