| NPI | 1437192085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX K2359) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K2359) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2010-09-21 |