| NPI | 1992777098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G25917) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-12183) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 17282) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 31698) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2007-07-08 |