| NPI | 1427151331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 39426) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 20912) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 24503) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 29637) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |