| NPI | 1336675396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101266010) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101266010) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-07-22 |