| NPI | 1427004126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 54862-20) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301073166) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2022-07-06 |