| NPI | 1083671333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-23189) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 112406) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2014-02-07 |