| NPI | 1164493375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: SC 85866) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: VA 0101047358) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 85866) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2021-07-19 |