| NPI | 1447289251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 646-320) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101257831) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 39250) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-03-17 |