| NPI | 1184685877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101226872) |
| Additional Taxonomies | 2084P0805X (Licence: VA 0101226872) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2014-05-22 |