| NPI | 1275699217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX D3418) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C29607) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 4694) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-08 |