| NPI | 1366482507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 017442) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 017442) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-02-01 |