| NPI | 1962813394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2023-01574) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-18715) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T0468) | |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2023-09-28 |