| NPI | 1043289069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0065259) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NE 19176) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2024-03-06 |