| NPI | 1154428936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR MD11976) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: OR MD11976) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-10-25 |