| NPI | 1457376105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0054335) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AL DO-609) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-10-11 |