| NPI | 1003905670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200401547) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: SC 28620) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NC 200401547) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 28620) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2016-08-25 |