| NPI | 1043229198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101025915) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 25915) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2016-04-06 |