| NPI | 1093945727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101260238) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA R-8537) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2016-08-02 |