| NPI | 1184965667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MO R7B57) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: KS 20745) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: TX E8670) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NE 18364) | |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-08 |