| NPI | 1982675575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA a93027) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME124219) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01058341a) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2021-04-01 |