| NPI | 1053309260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: PR 14240) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: PR 14240) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2025-09-23 |