| NPI | 1194761015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA OS004324L) |
| Additional Taxonomies | 2084P0805X (Licence: PA OS004324L) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2011-12-15 |