| NPI | 1467415620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101238996) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 088) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2020-06-18 |