| NPI | 1033287941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 10979) |
| Additional Taxonomies | 2084P0805X (Licence: MI 4301068192) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2012-11-01 |