| NPI | 1265428551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: LA 008728) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: LA 008728) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: LA 008728) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2015-02-25 |