| NPI | 1225295413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101248744) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MD D0067530) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2016-01-28 |