| NPI | 1336228303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0052071) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: UT 51508971205) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-10-28 |