| NPI | 1356308126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: MA 51517) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 51517) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 51517) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2025-09-11 |