| NPI | 1063537249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 55683) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 23641) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD6535) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101241572) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2009-11-02 |