| NPI | 1114065612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00010587) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA MD009959) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01034937A) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |