| NPI | 1033176755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 006223) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 44430) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC DO 565) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-11-04 |