| NPI | 1053515650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX BP1-0022964) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2009-01617) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2009-08-26 |