| NPI | 1356570550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP60521103) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ R1933) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2021-11-06 |