| NPI | 1346405024 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL DO.2836)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS12276)  | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101017872)  | |
| Enumeration Date | 2008-07-22 | 
| Last Update Date | 2023-12-04 |