| NPI | 1033448071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA OS017882) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: DE C20011412) |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2017-02-20 |