| NPI | 1073538468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 15350) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 6446) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 41276) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2016-11-22 |