| NPI | 1447213400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL me29106) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME29106) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2014-01-08 |