| NPI | 1396779385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0031176) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: MD m21440) |
| 173000000X Legal Medicine (Licence: MD bl0369656) | |
| 174400000X Specialist (Licence: MD d31176) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-09-13 |