| NPI | 1457450777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301095624) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 45475) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M-15188) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-12-23 |