| NPI | 1326034547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AR C5483) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: AR C5483) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2021-08-19 |