| NPI | 1023109246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 116163) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL OS14154) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KS 05-27360) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2018-09-12 |