| NPI | 1114029766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NH RT 1201) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: NH RT 1201) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VT 0420011417) | |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2013-03-26 |