| NPI | 1104871243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL MD.20541) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 20541) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2012-11-20 |