| NPI | 1083716328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 13496) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH RT1242) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042-0011312) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2010-05-12 |