| NPI | 1013986116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 11964) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV MD421741) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2024-12-18 |