| NPI | 1992810352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR MD25663) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD00044981) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A51676) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-02-04 |