| NPI | 1184648354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WV 23918) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MD D0059602) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2016-02-18 |