| NPI | 1154787158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101262991) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: VA 0101262991) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2026-08-25 |